- "You got some balls coming back."
- — Antonio Balsamo
Tony is an aging soldato in the Falcone Crime Family and has worked for them almost twenty years. Before Carlo Falcone took over the Moretti crime family, Tony was Tomaso Moretti's personal driver. He was badly injured when Falcone assassinated Moretti with a car bomb in 1933. Since then, he has spent most of his time working the Falcone family's protection rackets. His most recent assignment is to protect the family's accountant, Harvey "Beans" Epstein, and the secrets he holds. 
Working with Joe
When Joe Barbaro left Empire Bay for five years to live down south, Tony watched over Joe's Apartment. Upon Joe's return, Tony got him work with the Falcone family. He coordinated a stolen car ring that they were running in partnership with Derek Pappalardo, for which Joe was initially put to work on. The pair later stole a shipment of military grade weapons from the Southport docks, and afterwards he introduced Joe to Eddie Scarpa at the Garden of Eden. They later robbed Maxwell's Supermarket and made off with a substantial amount of money.
While Tony and Frankie the Mick were assigned to protect the family's accountant, Harvey Epstein, the three were kidnapped by the Clemente Crime Family. They were taken to the Clemente Slaughterhouse to be interrogated by Luca Gurino about Falcone's drug operation, which resulted in Frankie's death. Vito Scaletta managed to rescue the pair, and then Tony and Vito fought off Gurino and his crew. Tony later killed Gurino by torturing him with a cattle prod before putting him through a meat grinder.
When the Empire Bay Triads declared war on the Vinci Crime Family, thinking they were responsible for the death of Zhe Yun Wong and their men at The Red Dragon, Tony was severely beaten by Vinci's men, who were looking for answers. His injuries were so severe that Mafia doctor El Greco stated he'll likely never walk again.